vbac

FEATURED Guest Mama Blogger: The Triefler Tribe on the topic of VBAC

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I spoke to Michelle for the first time in the beginning of July of last year. She initially reached out to me to get my input on Boca Raton Regional Hospital. I am a huge supporter of mamas choosing this hospital for their births, especially when moms are trying for a VBAC (vaginal birth after c-section). Over the last four and a half years I’ve been to many hospitals from Jupiter through North Miami and have really gotten to see various hospital restrictions/policies and the way labor and delivery is run from hospital to hospital, and under larger hospital umbrellas like Broward Health, HCA, etc.

Back in July, Michelle reached out to me asking what would happen, if a rupture occurred or a c-section needed to happen. I immediately recommended to interview the practices who deliver at Boca Regional who do VBAC, and since Michelle was specifically interested in midwives (Certified Nurse Midwives) for her delivery, I suggested the practice that most of my VBAC clients have chosen over the last two years to VBAC with — Courtney McMillian, CNM and Polina Goldenberg, CNM at Boca Midwifery. Michelle and I chatted back and forth for about a month on facebook messenger and I shared all my knowledge of the previous successful vbacs I had attended with her during this time. I was really happy for her when she told me she had met with Boca Midwifery and decided to leave her OBGYN in Port St Lucie who did not do VBACs and hire the CNMs at Boca Midwifery for her trial of labor in hopes of a successful VBAC. I was so happy this mama would have the best chance at a VBAC. Her midwives and their backup OB Dr. David Lubetkin currently have a 13% c-section rate, and a very high rate of successful, smooth and safe VBAC deliveries.

In Michelle’s guest blog post below, she shares with us the story of how she planned for her VBAC and her amazing birth story. I invite you to check out and follow Michelle on her amazing Triefler Tribe blog here

➡➡➡➡ thetrieflertribe.com

Where she shares personal stories of her own infertility struggles, talks about her motherhood journey and what it’s like being a girl mom (and now has one child of each gender!) and compares her first pregnancy journey to her second.



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When we found out we were pregnant again, naturally this time, after conceiving our daughter via IUI and given a 3% chance of conceiving on our own, our world was turned upside down in the most beautiful way. Having had a c-section with my daughter at 37 weeks for suspected IUGR and breech presentation, I knew this time I wanted a VBAC. I knew that in order for that to be possible, I needed to have a home birth or to find a hospital and provider willing to take me and allow me to attempt a VBAC. I wasn't a big fan of attempting a VBAC at home so I joined a VBAC support group on Facebook and was given a wealth of knowledge of where to go and who to see. That meant having to travel an hour and a half south of where I live in order to have the BEST chance of being successful.

I started going to physical therapy and a chiropractor to make sure my body was aligned and in the best shape possible. I needed to do everything in my power to make sure my son had enough room to turn head down, unlike his stubborn big sister!

The day before I went into labor, I went to physical therapy and had acupressure done.

From my previous midwife appointment the week before, I was already 3 cm dilated, 50% effaced, and my son, Weston's, head was at a 0 station so he was getting ready to arrive any day! Contractions started that night but weren’t consistent. The next day, I had my midwife appointment at Boca Midwifery. They checked me and I was still at a 3 but 90% effaced. We went all the way home and I started having irregular contractions all day long. They got to a point where they were getting uncomfortable so we decided that it was time to head down to Boca once again. My midwife was very confident that I was in early labor. Luckily, Aaron and I were able to put my daughter, Peyton, down to sleep for the night. I was bawling my eyes out because I felt in my heart that I was putting her to sleep for the last time before we brought her brother home. My in-laws came over and Aaron and I left the house for the last time without our little girl.

When we got to the hospital, at around 10:30 p.m. my contractions slowed, of course. I was still admitted and the night was only getting started. We waited a while and I started bouncing on my ball and walking around and things started picking up again. My parents decided to start heading down south, my midwife arrived at the hospital, and my doula was there shortly after. While Aaron got some last minute sleep in, my doula and I started walking the halls. Contractions started getting more regular and more painful. I was dilated to about a 4 now. (Side note: I will say that I am the WORST with cervical checks. I can hardly get through them). I decided to get into the labor tub that we rented which was SO worth it. It really helped.

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Having a doula was invaluable.

My AMAZING doula, Lisa Raynor, was absolutely incredible. I could NOT have gotten through this without her. She knew exactly what to do for each contraction and her hip squeeze technique was just what I needed. It helped SO SO much. Not only was she there for physical support, her emotional support and knowledge helped me make decisions that I otherwise would have been so confused about. I will forever be grateful to her for all she did for us.

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So, I was in there for about 3ish hours when my midwife came to check again because my contractions were clearly extremely painful and very close together. I also started feeling some pressure so I was checked again and dilated to only about 5/6ish. So it wasn’t as much progress as expected and she asked if I wanted her to break my water instead of starting a low dose pitocin. I agreed, my water was broken, and I got back in the tub. Contractions from there were excruciating. I believe my water was broken at about 4 a.m. and by 6:30 a.m. I was completely and utterly exhausted. I was practically passing out in the tub in between contractions from laboring all that day and all throughout the night without any sleep. It was SO hard to keep my focus and I was really struggling. All I wanted was rest but these contractions weren’t stopping anytime soon.

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My midwife offered to check me again and I was SO hesitant and the thought of another check, during these contractions, and having to mentally bounce back seemed impossible but I agreed. I wanted to know if I made progress… but when she was about to do it I freaked out. I was having horrible contractions, I was completely exhausted to the point that I wasn’t even making sense to myself, and mentally, the checks do not go well for me. I NEEDED to keep a positive and strong mindset and that wasn’t going to happen. I had to make a choice at that point. The anesthesiologist wasn’t going to be available until after 8:30 a.m. The thought of not having any sleep since the previous day and eventually having to push really didn’t sit well with me. As much as I wanted to do this naturally, the circumstances weren’t in my favor and I agreed to get the epidural.

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I felt a bit defeated, I’m not going to lie. I wanted the natural birth experience. It seemed like everyone in the room understood what I wanted but also knew that I was past the point of complete and utter exhaustion from being up for 24 hours and we weren’t sure how much I progressed at this point. The epidural went very well. It was basically painless and it was an instant relief from all of those horrific contractions. My midwife came back in to see what I progressed to since I was open to the check since I was numb and I was at a 6 still. At this point, any feelings of defeat of getting the epidural were GONE because if I didn’t get it and I knew that I didn’t progress after ALL OF THAT PAIN and having to go through another check… it would have put me over the edge. I was so disappointed. No one gave up on me though and everyone had to help me mentally get back in the game.

So I rested. It felt so good to finally relax and let my body do what it needed to do in a restful state of mind and in calm body.

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They started me on a low dose pit to try to get some progression going.

When I say low, I mean like at a 0.5. While I rested, my husband, midwife, doula, and birth photographer all went down to get some food.

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Shortly after, they were all back in the room but not because they were done eating. Weston started having heart decels during my contractions. My blood pressure was dropping. So they had me switch sides to see if that helped and it did for a little while.

They stopped the pitocin to let the contractions slow down a bit and to make sure his reserve was still good.

After 30 minutes, all was well, and they started the low dose pit again. They started it and my body and Weston DID NOT like that. I was having a 3 minute long contraction and he was struggling in there. I kept asking what was going on and is everything okay, but everyone was SO busy and bustling around, flipping me back and forth… I knew something was wrong. They were just about to give me terbutaline to stop the contraction but they put me on my back first and it stopped so I didn’t need the medication. They stopped the pitocin completely. At this point, if things continued to go this way, with no progression, it was looking like a repeat c-section. My midwife and back up OB have a very low tolerance for heart decels and their main goal is for a safe mama and baby.

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I knew that things weren’t looking great when my midwife sat down and explained to me that a VBAC was not a guaranteed thing and that this was a TOLAC (trial of labor after csection).

TOLAC (trial of labor after csection)

My heart sank and my husband, Aaron was sitting by my head trying to make me feel better. Of course I wanted a healthy baby and for me to be okay after all of this, but I couldn’t help but feel so SAD that I did so much during this pregnancy to give myself the BEST chance at a VBAC and that this was happening the way it was.

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My ANGEL of a nurse, Mary Jane, I will never forget her for as long as I live. I knew her for a few hours, but she is probably one of my favorite people ever.

She was the EXACT nurse I needed for this experience.

She had asked me earlier that night if I prayed. I told her no. After all of these hiccups, I was laying on my side toward Aaron, she came over to my other side and I heard her whisper in my ear “I know you don’t pray, but can I please pray over you”. I said yes, of course. She started the prayer with everyone surrounding me in the bed and it was such a calming experience. She has such a calming voice. After she did this, things were starting to look up. It was absolutely incredible.

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Later on my midwife checked me and I was STILL at a 6 after all of that time!! She asked if I had any procedures done on my cervix because there seemed to be scar tissue there. I said no, because I haven’t. I have no clue what that was about. Now we knew why I wasn’t progressing. She started to massage my cervix (I didn’t feel a THING from the epidural, but I felt this, and it was a LOT of pressure. If I didn’t have the epidural and she had to do this, I would have lost my mind). She took her hand out and said “you just went from a 6 to an 8”.

ALL WAS RIGHT IN THE WORLD!

That was when I knew that getting the epidural was the right choice for me. I would have continued to labor, hard, with no progression because of some issue with my cervix. This is why I am so glad I had the care that I did. Instead of just giving up and rushing this VBAC attempt into the O.R., they did everything they could for me. After that, things were going SO well. The vibe in the room changed and everyone was chatting and laughing and truly enjoying one another. I had some energy back, my positivity was back, and Aaron looked at me and said “the vibe in here has completely changed, let’s keep this going”.

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We were all having blast and soon enough his head was coming out of me and it was time to push! This was my favorite part of the entire experience. We were all laughing and joking around while everyone is staring at my vagina waiting for more of his hair to come out! I was surrounded by Aaron and a bad ass tribe of women.

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My mother, my nurse MJ, my midwife Polina, my midwife Courtney, my doula Lisa, and Paulina, my birth photographer. The most amazing birth team I could have ever asked for. I can’t even begin to express how much I love each of these women and what they did for me and baby Weston. They kept us safe, they never gave up on me, they didn’t give up on him and they helped me achieve the birth experience I have always dreamed about.

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I pushed for less than an hour and Weston was HERE. Born January 18, 2019 at 12:45 p.m. weighing 8 pounds 3 ounces and 20.5 inches long. He was put directly on my chest and it was the most blissful experience in the world. I was so relieved and said “WE DID IT”. The feeling in the room was incredible and I am so happy with how everything turned out.

I couldn’t be more grateful to EVERYONE at Boca Regional Hospital.

The most incredible staff I have ever known. Every single person is rooting for you, wants what is best for you, and takes care of you.

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I do want to talk about something else. I want every woman reading this to know that you have a choice. You have a choice in how and where you want to birth, no matter if you had a previous c-section or not. You have the right to exceptional prenatal care.

You have the right to NOT be traumatized by your birth/ birth team.

Birth doesn’t always go exactly as planned. Mine didn’t both times. But this time, I had support, I had a fantastic birth team, and I had a voice. I feel so content and happy with my birth experience. I want every woman to feel the way I do. You deserve it!

Thank you Michelle for an amazing guest blog post!

I invite you to check out and follow Michelle on her amazing Triefler Tribe blog here

➡➡➡➡ thetrieflertribe.com














Stunning Images of Midwife Delivering Baby for Two Previous C-Section Mama Has us Stunned and Seriously in Love

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Words from the mama: 

"I am still in shock and awe at what God can do. My pregnancies have been very difficult, from Aaden's loss to complications in Brooklyn's birth (both ending in c-sections). I always dreamed of having a birth without complications, where I could just enjoy my baby. This was it.

I had the best support and birth team I could ask for. Everyone was patient with me and my concerns and considered my history. I couldn't ask for more. Thank you to Lisa Raynor my doula, Courtney McMillian my midwife at Boca Midwifery, Paulina Splechta my birth photographer and birth film maker, and of course my husband David. I literally could not have labored nor survived this pregnancy without you."   - Jocelyn

Boca Raton Regional Hospital, Boca Raton, Florida

Boca Raton Regional Hospital, Boca Raton, Florida

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When I first met Jocelyn, I was so emotionally tied to her and excited for her and also a little bit anxious. I am a two time cesarean mommy myself (neither was planned) but I never had an amazing birth team the way Jocelyn had for this pregnancy, so I didn't know what to expect would happen at her labor and delivery with such an amazing team.

I was so excited for her to experience a vaginal birth and to meet and hold her baby immediately, and I knew it in my heart that this could only happen with Boca Midwifery. They understood her medical history and they cared for her the entire pregnancy, but it was a delicate journey Jocelyn had been on, from experiencing the loss of one of her children and complications with her daughter Brooklyn's birth, and I was anxious to witness the birth of baby Riley. I didn't know if we would witness her having a vaginal delivery or if we would have to go into the operating room. I feel the entire labor and delivery staff was rooting her on at Toppel Family Place (The labor and delivery unit of Boca Raton Regional Hospital in East Boca [off of Glades Road, just east of I-95]). 

A lot of birth workers uncover a deep passion for their work due to their own emotional and personal history, and with me, it is completely true. Originally, I wanted to test the waters four years ago when I photographed my first birth. But once I captured that birth for my client, I knew this is where my heart belongs and its become so much more than photography over the last four years. 

In all this time, four years, I had never witnessed a vaginal delivery after TWO CESAREANS. I had attended many VBACs (vaginal delivery after cesarean) with Boca Midwifery, Women's Health Partners, Dr. Skeete down in Ft Lauderdale, and vbac home births with midwives Gelena Hinkley, Sandy Lo, Mary Harris. But I had in all this time never seen a mommy successful deliver a baby vaginally after having two previous c-sections. And the reason I haven't before seen a vbac after two c-sections is not entirely that the trial for a vbac after two csections failed with previous clients. It's not that at all.

It's that often times the mommys who have had two csections stay with their provider who automatically schedules a repeat third csection for them with their third delivery. These moms are simply not aware of the option to try for a vbac after two c-sections. No one has even told them that its physically possible to achieve. And what the benefits to having a vbac are instead of scheduling a repeat cesarean. Most of the vbacs I have documented in my four years as a birth photographer here in south Florida have been moms who had a c-section with a practice (sometimes traumatic, physically or on an emotional level) and change practices, hoping for a more positive, empowered and supported experience for their subsequent pregnancy to a practice heavily experienced in achieving safe and successful VBACs. Many of my VBAC birth clients with Boca Midwifery have exactly this story. 

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As Jocelyn's entire birth team stood around her during her final pushes, I thought to myself, "this is happening, this mama is going to meet her baby right now"

I felt the tears begin to swell up in my eyes, I tried to hush them and focus on capturing this incredible moment. I stood near mom's shoulders, making sure that her midwife was blocking any angles that would prevent Jocelyn from being able to share photos from her birth story with her family and friends, I looked up at Jocelyn and her husband David, they were smiling at each other, at their doula and midwife, at me. Their doula, Lisa Raynor, was proudly beaming a smile back at them and at me. Baby nurse Donna was eagerly waiting to meet their sweet baby, also wearing a proud smile for mama. Her midwife, Courtney McMillian, was focused and positive and their nurse Peggy knew this moment was about to happen.

This moment would contribute to the shift in the change of the world's view of birth. A successful vbac after two cesareans for Boca Midwifery, for the labor and delivery staff at Boca Raton Regional Hospital, but most importantly, a footprint in the history of birthing women, showing them, that with the right support and birth team for your pregnancy, skilled vbac professionals who have a great deal of patience and success rates, a vbac after two csections is possible.

Knowing this fact, it put chills on my back. 

Knowing that maybe someday, I too could experience a vbac, after my two unjust csections with previous providers and birth teams who had failed to support and encourage me in the ways I needed.

You can watch the film of the birth of Riley below:

Jocelyn's two-time cesarean scar and baby Riley's teensy feet

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